Perioperative Allogeneic Blood Transfusion Does Not Cause Adverse Sequelae in Patients With Cancer: A Meta-Analysis of Unconfounded Studies

Deleterious clinical effects of transfusion-associated immunomodulation: fact or fiction?

“…22 There was also agreement among the findings of these RCTs (Figure 3), as the noted variation in reported results was sufficiently modest to be attributed to chance (P Ͼ .10 for the Q test statistic). 55 Accordingly, the findings of the studies were combined in 2 meta-analyses, 24,25 and the summary OR of cancer recurrence in the allogeneic transfusion (compared with the control) group across the 3 studies was 1.04 (95% CI, 0.81-1.35; P Ͼ .05) (Figure 3). The summary OR of death due to cancer recurrence was 0.98 (95% CI, 0.76-1.26; P Ͼ .05).…”

“…5 Jensen et al 3,5 did not present information on some important potential confounding variables (eg, Dukes stage of tumor and tumor fixation to adjacent organs), allowing one to speculate that the observed large TRIM effect (Figure 4) could be due to the effects of uncontrolled confounding factors. 24,25 In addition, selection bias and observation bias are possible in RCTs despite the randomized design and the blinding of investigators, respectively. 94,95 In the RCTs of Jensen et al, 3,5 sicker patients may have been systematically allocated to the treatment arm, and/or investigators who became aware of the treatment allocations may have been inclined to diagnose postoperative infection more often in patients from the treatment arm.…”

“…[15][16][17][18][19][20] In addition, 7 randomized controlled trials (RCTs) have compared the risk of cancer recurrence 2,21,22 and/or postoperative infection [3][4][5][6][7][21][22][23] between a treatment arm receiving standard 7 or buffy-coat-reduced red blood cells (RBCs) 2,[4][5][6]21,22 or whole blood 3 and a control arm receiving autologous or white blood cell (WBC)-reduced RBCs or whole blood. 24,25 These studies are based on the assumption that the transfusion of autologous 2,4,21,23 or WBC-reduced 3,[5][6][7]22 RBCs, or whole blood, is immunologically neutral. Both the earlier observational cohort studies and the recent RCTs have produced contradictory findings, and-because of the discrepancies among the published studies-the long-standing hypothesis of the potentially deleterious immunomodulatory effect of perioperative allogeneic blood transfusion remains unresolved.…”

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

“…Some of these studies have shown an adverse effect of transfusion on the prognosis of patients with colorectal carcinoma [4][5][6]. Conversely, others have found no transfusion-dependent effect on survival and recurrence [7,8].…”

Blood Transfusion Practices in Major Orthopaedic Surgery

“…Randomized control trials using both leucodepleted blood and autologous blood have not demonstrated an increase in either the risk of cancer or infection (Goodnough 2000;Jensen 1998). A meta-analysis of three randomized control trials and two cohort studies where control groups received either leucodepleted blood or autologous transfusion found no significant differences in cancer recurrence (McAlister 1998).…”